Where's that thumb been? Thumb-sucking is perfectly normal, but it makes many parents worried. Family members often shake their heads in disapproval. Strangers comment that perhaps your child is overly anxious. Yet, research shows that children who continue to suck their thumbs beyond the preschool years don't have more emotional problems than their non-thumb-sucking peers.

So why do kids do it? Thumb-sucking starts out as a way for children to self-soothe, then becomes habit. And like any habit, it can be hard to break. Sandra Coulson, a Certified Orofacial Myologist, says, “Children (and adults) suck their thumbs for relaxation provided by the release of endorphins and serotonin when the thumb is pressed into the palate with the force of the tongue.” She treats thumb-sucking as an 'addictive' behavior, not a psychological issue. She believes, therefore, that it can be corrected with positive behavior modification and recommends against a punitive approach.

So how old is too old for thumb-sucking? When do you need to step in and help your child stop? And how?

Slow and steady wins the race. According to Dr. Virginia Shiller, licensed clinical psychologist, reward plans are the way to go. “Reward plans that aim to slowly but systematically wean children of this habit can be very effective. It is helpful if children have some personal motivation to get themselves to stop.” Says Dr. Shiller, children around the ages of 4 or 5 are more likely to cooperate with a suggested plan, and will have more motivation. As children get older they may receive negative feedback from peers, which can also push them to stop, but may have trouble breaking this habit on their own. A step-by-step plans with modest incentives can give them the help they need.

Enter Dr. Shiller’s TICKET program. With this plan, you and your child choose particular times during the day where your child will avoid sucking her thumb. Each time she accomplishes the goal, she gets a ticket. Keep building on her successes by adding longer times throughout the day. Offer her something to hold during these times or put a Band-Aid on her thumb to remind her not to suck.

Decide on a reward for her efforts. For example, four tickets might give her the ability to choose dinner for the night, or eight tickets might mean she can rent a movie. You don’t need to run out to the toy store every time she resists her thumb for an hour. The rewards can be small, like a special snack, an outing to the beach, or time with just the two of you (no siblings allowed!). According to Shiller, with patience and consistency, your child will grow proud of her accomplishments and the habit will become a thing of the past.

For those not interested in a rewards program, there are plenty of other options. For example, Thum, a product you paint on your child’s fingertips that contains a bitter tasting, but harmless vegetable product. Its purpose is to act as an immediate reminder whenever the child puts his thumb in his mouth. Careful, though. Thum is made with cayenne pepper, so make sure your kid can remember not to rub his eyes! There’s also Thumbguard™, a plastic device that fits over the thumb and secures at the wrist, denying access altogether. With both of these products, make sure your kid’s on board with making their thumb sucking history. Otherwise, it can seem punitive and may only serve to make the child more adamant.

Whatever method you pursue, you’re doing your child’s dental hygiene and self-esteem, not to mention your own wallet, a big favor by getting her to break the thumb sucking habit early on. And that’s not something to thumb your nose at.